Wednesday, April 22, 2009

Starting the MS Engine

Since I was first diagnosed with Multiple Sclerosis six years ago, I've probably been asked a thousand times, "What causes MS?" Seems like a pretty simple question, but the unfortunate truth is that nobody knows the root cause of Multiple Sclerosis. As with cancer, diabetes, and a host of other diseases, decades of research have allowed our best medical minds to only make educated guesses as to the genesis of the MS. Over the last 20 or so years, the prevailing hypothesis has been the "autoimmune" theory, which states that a patient's immune system for some reason goes haywire, and starts attacking their own cells. I often get the sneaking suspicion that diseases whose cause stumps our scientists are often labeled autoimmune, simply for lack of a better theory. Modern science isn't comfortable saying "I don't know", and when I see the word "autoimmune", I often put the words "I Don't Know" in its place. Multiple Sclerosis is an "I Don't Know" disease.

Through the years, I've come to look at the MS disease process as kind of resembling an automobile engine. In order to start a car engine, you must have gasoline in the tank, oil in the pan, and a key for the ignition. If one or two of these elements are missing, the car just won't start. In much the same way, MS requires a number of elements to be present for it to take hold of a patient's physiology. There is solid evidence that bacterial or viral infections play some part in the disease. Likely culprits include Epstein-Barr virus, Chlamydia Pneumonia, Varicella Zoster, and the Human Herpes Viruses. Many of these bugs infect large proportions of the population; for example, EBV is present in at least 85% of adult Americans. Obviously, only a tiny proportion of them develop MS, so EBV alone can't be the cause of the disease. There is also strong evidence that environmental toxins play a role in starting the MS disease process. Again, though, the vast majority of people exposed to common environmental toxins don't come down with MS. Therefore, there must be another component required for MS to take hold, most likely a genetic susceptibility.

It's been theorized that some people carry within their DNA remnants of ancient retroviruses that have over the eons incorporated themselves into the human genome. This retroviral DNA is normally inactive and completely benign, but perhaps the presence of a combination of infections and/or toxins can activate this DNA, and thus cause a person's immune system to see their own cells as harmful invaders.

So, to get back to the engine analogy, for a patient to get MS, they must have gas in the tank (a chronic viral or bacterial infection), oil in the pan (exposure to another environmental toxin or infectious agent), and a key to the ignition (a genetic predisposition to the disease). Without the right combination of elements present, even a person genetically susceptible to MS might never get the disease. Likewise, without genetic susceptibility, a person might be exposed to any number of MS triggers, and never develop Multiple Sclerosis. In my opinion, it's an unfortunate synchronicity of seemingly unrelated elements that turns the key that starts the MS disease engine. These elements may differ from patient to patient, and these differences in triggering elements might account for the vastly different ways that MS can present itself from case to case.

Hi Marc, I can't remember how I found your site, but your comments during your videos really made me laugh (and that's hard to do). I'm in AZ and have never been to NY, so I appreciated your stroll(I mean roll) thru Central Park. I will be visiting your site often, as I need to laugh! Thanks so much! I've fallen off my scooter in the house & my husband threatens to post Speed Limit signs-!

Ahhh..synchronicity. I know that well. My doctor told me all the stars lined up for my diagnosis. I like to think of it as the pinball machine hitting TILT.1. grew up in the northeast in a cold climate2. mother had MS3. had a serious Vitamin D deficiency4. came down with a 9 month long case of Epstein Barr virus infection (othewise known as mono) about a year before my diagnosis.

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Regretfully, due to the high volume of e-mail received and the realities of living with progressive MS, I'll no longer be able to respond to all e-mails sent. I do read each note, and will do my best to answer as many messages as I can.

About Me

I'm Marc, a 53-year-old male, living in New York City with my lovely and wonderful wife Karen. Diagnosed with Primary Progressive Multiple Sclerosis in March of 2003, I now require a wheelchair to get around the city. I like to drive the wheelchair at full speed, thus the moniker "Wheelchair Kamikaze". I've managed to rig a camera to my chair, so I'm able to take videos and still photos from the unique vantage point of a wheelchair, which I intend to post here.
Before getting sick, I was the Director of DVD Production for one of the major international music companies. Yes, I was once a member of the Evil Empire...
Prior to my enlistment in the Evil Empire, I worked as a video producer and editor.
I grew up in New York City, and spent the 1980s in Boston (college and postcollege rock 'n roll craziness). During the 1990s, I lived in South Florida, until I woke up one morning and realized I was living in South Florida, came to my senses, and moved back to New York.
I hope you like my blog...